Mrs. Twoweek has been your patient for 12 years. She is compliant and returns every October for her yearly examination. Each year she reports that she's doing well with her contact lenses, which she disposes every two weeks. Each year you give her the same lenses, plus or minus a quarter
diopter.

Consequences of Habit

With this backdrop, don't be surprised if one day you get a fax from an online contact seller asking for Mrs. Twoweek's prescription. After all, in the patient's mind, what true services are you offering her that the other lens retailer can't?

"Ah, Gary, you don't know my practice!" you might say. "I offer her an examination and follow up, and she can't get that online!" you proudly state. "She is buying her lenses elsewhere only because she thinks she can save money on the Internet."

Not exactly.

In the case I've outlined, you have not given Mrs. Twoweek a compelling reason to return to your practice other than for your professional care. Indeed, her yearly visits and your response to them have become nearly Pavlovian -- Patient comes in wearing Brand X, patient reports no problems with Brand X, patient leaves with Brand X.

Examined in a broader sense, you have become a human contact lens vending machine. And because vending machines have no personality or soul, your patients can reasonably use another machine if they perceive that it is more convenient and less expensive. "Hey doc, it's nothing personal -- I'll still come to you for my eye exam, but a lens is a lens is a lens..."

Vending machines function on the premise that they contain commodity products that require no education or skill to dispense. Consumers feel comfortable using vending machines because they have a positive history with their products. Throughout her years in your practice, Mrs. Twoweek has grown comfortable and brand loyal with the same eight boxes of lenses you've been giving her every year -- just like a vending machine.

Try Something New

As new modalities enter the contact lens market, make sure you tell patients that you have something newer and better. Even Mrs. Twoweek likes to know that her doctor is at least aware of the latest contact lens technologies -- even if they might not apply to her particular case and even if she might not be interested. She wants to feel like her doctor is watching out for her best interests, like her doctor should!

You owe it to your patients' ocular health and your practice's health, longevity and bottom line to stop prescribing the "same
ol' same ol'" year after year and start offering patients newer and better contact lenses.

With newer polymers such as silicone hydrogels and expanded parameters in newer modalities such as daily disposable contact lenses, few among us can argue that older materials or modalities are healthier or safer for most of our patients.

Yet even though we are armed with this knowledge of superior products, many of us remain reticent in our recommendations to our patients. Fear of rejection and fear that the patient will perceive us as selling are the most common reasons practitioners have used for not discussing new technologies with patients. I caution practitioners that this attitude may ultimately result in another fear coming true -- fear of a significant exodus of patients.

Change for the sake of change? You bet! But also change for the sake of doing what's best for your patients.

Dr. Gerber is the president of the Power Practice ­ a company offering consulting, seminars and software solutions for optometrists. You can reach him at (800) 867-9303 or
DrGerber@PowerPractice.com.